This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Garrison, M. M.
Right arrow Articles by Davis, R. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Garrison, M. M.
Right arrow Articles by Davis, R. L.

PEDIATRICS Vol. 105 No. 4 April 2000, p. e44

ELECTRONIC ARTICLE:
Systemic Corticosteroids in Infant Bronchiolitis: A Meta-analysis

Received Sep 16, 1999; accepted Nov 19, 1999.

Michelle M. Garrison*, §, Dimitri A. ChristakisDagger , §, Eric Harvey§, Peter Cummings*, and Robert L. Davis*, Dagger , §

From the * Department of Epidemiology and Dagger  Division of General Pediatrics, University of Washington; and § Child Health Institute, Seattle, Washington.

Objective.  To determine whether corticosteroids are efficacious in treating bronchiolitis in hospitalized infants.

Methods.  Online bibliographic databases (Medline, Embase, and Cochrane Clinical Trials Registry) were searched for: 1) bronchiolitis or respiratory syncytial virus, and 2) corticosteroid or glucocorticoid or steroidal antiinflammatory agents or adrenal cortex hormones. Reference lists from all selected articles were also examined. Randomized, placebo-controlled trials of systemic corticosteroids in treatment of infants hospitalized with bronchiolitis were selected by 2 investigators. Of 12 relevant publications identified in the literature search, 6 met the selection criteria and had relevant data available. Investigators independently extracted data for 3 outcomes: length of stay (LOS), duration of symptoms (DOS), and clinical scores.

Results.  In the pooled analysis, infants who received corticosteroids had a mean LOS or DOS that was .43 days less than those who received the placebo treatment (95% confidence interval: -.81 to -.05 days). The effect size for mean clinical score was -1.60 (95% confidence interval: -1.92 to -1.28), favoring treatment. Secondary analyses of mean LOS or DOS were performed on 5 trials that had clearly identified methods of randomization, 5 trials that measured LOS, and 4 trials that clearly excluded infants with previous wheezing. The estimates of effect were similar to the primary analysis but were not statistically significant.

Conclusions.  Combined, published reports of the effect of systemic corticosteroids on the course of bronchiolitis suggest a statistically significant improvement in clinical symptoms, LOS, and DOS.  Key words:  bronchiolitis, corticosteroid, anti-inflammatory agents, steroidal, meta-analysis, infant.




This article has been cited by other articles:


Home page
 cfpHome page
G. Worrall
Bronchiolitis
Can Fam Physician, May 1, 2008; 54(5): 742 - 743.
[Full Text] [PDF]

Home page
 AAP Grand RoundsHome page
M. Weinberger
Corticosteroids Revisited for Acute Bronchiolitis in Hospitalized Children
AAP Grand Rounds, August 1, 2007; 18(2): 13 - 13.
[Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
A. R. Kemper, E. J. Kennedy, R. E. Dechert, and S. Saint
Hospital Readmission for Bronchiolitis
Clinical Pediatrics, July 1, 2005; 44(6): 509 - 513.
[Abstract] [PDF]

Home page
 AAP NewsHome page
N. Kuppermann
Research network studying corticosteroid use for bronchiolitis
AAP News, February 1, 2005; 26(2): 12 - 13.
[Full Text] [PDF]

Home page
 AAP Grand RoundsHome page
R. I. Paul
Steroids and the Acute Management of Viral-Induced Wheezing
AAP Grand Rounds, March 1, 2004; 11(3): 31 - 32.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
C. B. Hall
Managing Bronchiolitis and Respiratory Syncytial Virus: Finding the Yellow Brick Road
Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 111 - 112.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
V. J. King, M. Viswanathan, W. C. Bordley, A. M. Jackman, S. F. Sutton, K. N. Lohr, and T. S. Carey
Pharmacologic Treatment of Bronchiolitis in Infants and Children: A Systematic Review
Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 127 - 137.
[Abstract] [Full Text] [PDF]

Home page
 AAP Grand RoundsHome page
P. C. Stillwell
Dexamethasone for Severe RSV-Induced Acute Respiratory Failure: Help or Hindrance?
AAP Grand Rounds, August 1, 2002; 8(2): 19 - 20.
[Full Text] [PDF]

Home page
 Evid. Based Nurs.Home page
Other articles noted
Evid. Based Nurs., October 1, 2000; 3(4): 106 - 112.
[Full Text]